What’s All the Fuss about Complex Trauma?

For those of us who work with troubled children and youth it is obvious that their lives have been filled with difficult relationships, traumatic events, and high levels of stress. So why is this relatively new focus on complex trauma and trauma-informed practice so important? Don’t we already know enough to make a difference? – That a stable, caring adult relationship can make a huge difference. That safe places and safe people are crucial? Most of us are familiar with Post Traumatic Stress Disorder (PTSD) and the idea that traumatic events can leave their mark and affect a youth’s level of anxiety, undermine their self-esteem, and lead to heightened reactions and intrusive thoughts, etc. It makes sense that those children who have experienced more Adverse Childhood Experiences (ACEs) will fare worse in life and that these experiences can lead to things like alcoholism and addictions, poor outcomes in education, and struggles maintaining a job and relationships. Hopefully, we approach these children in a sensitive manner which is the hallmark of trauma-informed approaches. So what’s all the fuss about Complex Trauma?

Trauma and a child’s developing brain

As a psychologist working within Child and Mental Health I often received referrals of children who were displaying a wide range of extremely difficult behaviours. These youth frequently arrived with a confusing set array of assessments, a long list of diagnoses, multiple medications, and an overwhelmed group of caregivers and professionals. From a clinical perspective, we often experienced frustration because the various therapies in which we were trained (both evidence-based and experiential) were often not particularly helpful. My entire perspective on these kids changed when I began to understand the profound effect that trauma has on the child’s developing brain.

Over the past two decades there has been a growing interest in complex trauma – or complex developmental trauma. This refers not just to (1) the compounding effects of multiple types of trauma and stressors on children’s lives, but (2) to the fact that trauma has a significant effect on the child’s developing brain systems. Complex trauma, or traumatic stress, can seriously interfere with brain and nervous system development and does so in an amazingly broad way, affecting not just a child’s behaviour or thinking, but rather almost every developing system in their bodies and brains (see for example Anda et al., 2006; Kisiel et al., 2014; Perry, 2006; Perry, 2009). Organizations such as the National Child Traumatic Stress Network and the Child Trauma Academy provide important education on the comprehensive developmental challenges that complex trauma histories produce. A series of three videos (link) from the Harvard Center on the Developing Child help to illustrate this principle.

A Game Changer

This core idea, that a child’s brain and nervous system (and thus all development) is profoundly affected by trauma, is a game-changer. It is a new paradigm that allows me to understand a bewildering array of symptoms in new way. This paradigm changes the conversation. No longer is it about establishing a diagnosis as if the diagnosis identifies something intrinsic and fixed about the child. Now my focus is on where development got stuck at a nervous system level and less on managing the behaviours we see on the outside. The conversation becomes one of how do we, as caring adults, create the environment and nurturing experiences for this child’s brain to re-wire and re-set. How do we move beyond managing the challenging emotions and behaviour to “see” and respond to the needs of the underlying over-reactive stress response? How do we add to our knowledge of safe relationships and attachment to help the child to recover from all of the adverse experiences (ACEs) before those experiences take a lifelong toll?

You are invited…

In this introductory blog for Complex Trauma Resources we want to invite you to dive into this journey with us. We’ve seen dramatic successes over and over again with children and youth in our foster care and adoption systems when we apply our understanding of complex trauma to assessment and treatment plans. We work with clinical teams and more importantly, parents, foster parents and residential staff to find simple and practical strategies to help children recover and thrive. The implications of a Complex Trauma understanding and lens are huge – for Child Welfare, for adoptive families, for family court systems, for education systems, and for caregivers. The same brain science teaches us about the negative effects of trauma also gives hope – that new experiences can change the trajectory of children’s lives.

If you’d like more information on complex trauma you may wish to consider joining CTR as a member.